Healthcare Provider Details

I. General information

NPI: 1841328796
Provider Name (Legal Business Name): CENTER FOR PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8800 UNIVERSITY PKWY C 2
PENSACOLA FL
32514-4927
US

IV. Provider business mailing address

8800 UNIVERSITY PKWY C 2
PENSACOLA FL
32514-4927
US

V. Phone/Fax

Practice location:
  • Phone: 850-478-1166
  • Fax: 850-478-4878
Mailing address:
  • Phone: 850-478-1166
  • Fax: 850-478-4878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH0002659
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY0002873
License Number StateFL

VIII. Authorized Official

Name: GARNET HOLMES
Title or Position: PARTNER
Credential: L.M.H.C.
Phone: 850-478-1166